Burin & Osório 2016
Let us begin our tour through the music performance anxiety literature with this little beauty.
This paper is an concise and thorough overview of current research into empirical studies from 2002 to mid 2016 and was published late in 2016 in a Brazilian Clinical Psychiatry journal.
Before I delve too much into the detail, I would just like to cut to the chase and announce the 'winner' is CBT (cognitive behavioural therapy) of which ACT is considered the 'third wave' of CBT. While it is distinct from original CBT (less 'challenging dysfunctional thoughts' and more 'watching those thoughts as they come and go, allowing them to be there') there are many concepts and processes that they have in common. I would personally like to ride on the CBT 'third-wave' successes if it helps more people to trust ACT to help them improve their lives.
This paper has basically done the hard work for me. It has filtered through all database searches, and manual searches from 2002 to July 2016 and reviewed the 23 empirically researched papers on music performance anxiety (MPA) interventions. Sadly though, it states that their review of the literature 'reinforces previous findings regarding methodological fragilities associated with this context' of MPA. The writers note that most studies had low numbers of participants and low level and quality of evidence for the effectiveness of the interventions. It notes that most studies were not experimental studies with inter-group comparisons and many have failed to use randomisation to assign subjects to the different groups - either comparison treatments or waitlist groups.
The paper is also concerned that a most of the subjects are young adult university music students playing piano. It also notes there is not many studies specifically into children and adolescents, and as it is acknowledged that many musicians begin to have difficulties performing (and develop MPA) when they are children, more study should be focussed on children - to prevent MPA if possible, or at least minimise conditions that lead to the development of MPA. The study also notes there were no studies of only professional musicians, and considering the damage to personal life and professional careers that MPA can inflict, this is another a gap in the literature.
Few of the studies were clear about how their subjects were either included or excluded from the study - come one, come all! Another interesting point is that a lot of the subjects were not assessed as to whether they were experiencing MPA before the study began, and if they do suffer from MPA there was no way of evaluating how serious the condition was for the subjects of the study. This is a question that I have pondered a great deal deal also, and the paper also states that there is almost an acceptance in the community that some level of stress/pressure/excitement is normal for musicians.
As I plan my research and study design I am looking for psychological measures for different outcomes, and this paper notes there does not seem to be a standardisation of measurement tools in these studies, so that it becomes very difficult to compare the effectiveness of different interventions. Some papers did not even include statistical analysis of the results.
Interventions used were CBT(6), yoga (4), meditation (4), virtual reality (3), biofeedback (3), music therapy (2) and one Alexander Technique study.
The article can be purchased at http://www.scielo.br/scielo.php?pid=S0101-60832016000500116&script=sci_abstract&tlng=en